|INT'AL CLASS'N OF DISEASES | AIDS GLOSSARY | ANATOMY | DRUGS | USA STATS | CHINA STATS | GENOME DICTIONARY|
HEALTH TOPICS A TO Z
Blood safety and donation
Safe Blood for Safe Motherhood
Globally, more than half a million women die each year during pregnancy, childbirth or in the postpartum period – 99% of them in the developing world. An estimated 25% of those deaths are caused by severe bleeding.
Postpartum bleeding is unpredictable and the quickest of maternal killers. It can kill even a healthy woman within two hours, if unattended. Blood transfusion has been identified as one of the eight key life-saving functions that should be available in healthcare facilities providing comprehensive emergency obstetric care. Access to a safe and sufficient blood supply could help to prevent the deaths of a significant number of mothers and their newborn children each year.
The impact that access to safe blood can have on health outcomes for pregnant women with severe bleeding is illustrated by Malawi. In 2003, the country established the Malawi Blood Transfusion Service. In 2005, the maternal mortality rate due to severe blood loss had fallen by more than 50%.
WHO has collected data from 172 countries, covering 95% of the world’s population, based on 2004 figures
Blood transfusion saves lives and improves health, but millions of patients requiring transfusion do not have timely access to safe blood. Despite advances in medical science, it will be many years before artificial blood substitutes can routinely replace the need for the donation of human blood. Every country needs to avoid blood shortages and ensure that blood supplies are free from HIV, hepatitis viruses and other life-threatening infections that can be transmitted through unsafe transfusion.
While the need for blood is universal, there is a major imbalance between developing and industrialized countries in access to safe blood.
Types of blood donation
The safest blood is donated by the safest blood donors. The prevalence of HIV, hepatitis viruses and other blood-borne infections is lowest among voluntary unpaid blood donors who give blood purely for altruistic reasons. Higher infection rates are found among family or family replacement donors who give blood only when it is required by a member of the patient's family or community. Worldwide, the highest rate of infection is found among donors who give blood for money or other form of payment. Adequate stocks of safe blood can only be assured by regular donation by voluntary unpaid blood donors.
The 2004 data reveal some tangible improvements since 2001-2002, but family/replacement donors and paid donors still remain a significant source of blood for transfusion in many developing and transitional countries.
WHO recommends that, at minimum, all blood for transfusion should be screened for HIV, hepatitis B, hepatitis C and syphilis. Complete and accurate data on the testing of donated blood are not available in the majority of developing countries, particularly in those where blood services are fragmented, but many do not yet have reliable systems for testing because of staff shortages, poor quality test kits or irregular supplies, and lack of basic laboratory quality systems. The advanced technology used in many developed countries is unable to detect very recent infections and is not affordable or cost-effective in most developing and transitional countries.
Data on blood utilization are limited, but studies suggest that transfusions are often given unnecessarily when simpler, less expensive treatments can provide equal or greater benefit. Not only is this wasteful of a scarce resource, it also exposes patients unnecessarily to the risk of serious adverse transfusion reactions or transfusion-transmitted infections.
Sources: US Department of Health; The World Health Organization